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<p>Breast cancer remains the most prevalent malignancy among women worldwide, making optimal treatment approaches like breast-conserving surgery (BCS) critically important. Gross margin examination (GME) serves as a valuable intraoperative technique to achieve tumor-free margins—a fundamental objective of BCS. This practical method offers multiple advantages, including reduced reoperation rates, shorter surgical duration, and lower healthcare costs compared to frozen section analysis. In this cross-sectional study, we enrolled 172 women with palpable tumors eligible for BCS through gradual sampling. Margin assessment incorporated dual verification: intraoperative visual and manual evaluation by surgeons to identify tumor-free margins, and final pathological confirmation. We additionally evaluated operative duration, cost reduction, and reoperation rates. All analyses were performed using STATA software (version 14). The cohort demonstrated a predominance of invasive ductal carcinoma (IDC, 69.2%), with GME showing excellent performance for this subtype (sensitivity: 100%; specificity: 96%). Overall, GME exhibited moderate sensitivity (45%) but high specificity (95%) compared to final pathology, with positive and negative predictive values of 59% and 92% respectively. Notably, the use of intraoperative frozen tissue section excision significantly reduced operative time. Our results support GME as an effective margin assessment method in BCS candidates. The technique demonstrates particular strength in IDC cases while offering the practical benefits of reduced surgical duration and healthcare costs. These findings suggest GME represents a viable alternative to more resource-intensive margin evaluation approaches, especially in settings with limited pathology support. Excision of frozen tissue sections during surgery significantly reduces operative duration.</p>

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Gross Margin Examination or Frozen Section in Women Who are Candidates for Breast-Conserving Surgery

  • 期刊论文

  • 发表日期：

    2025年8月15日

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  • Leyla Shojaee,
  • Kiarash Shakeriastani,
  • Elahe Hasan Amraji

摘要

Breast cancer remains the most prevalent malignancy among women worldwide, making optimal treatment approaches like breast-conserving surgery (BCS) critically important. Gross margin examination (GME) serves as a valuable intraoperative technique to achieve tumor-free margins—a fundamental objective of BCS. This practical method offers multiple advantages, including reduced reoperation rates, shorter surgical duration, and lower healthcare costs compared to frozen section analysis. In this cross-sectional study, we enrolled 172 women with palpable tumors eligible for BCS through gradual sampling. Margin assessment incorporated dual verification: intraoperative visual and manual evaluation by surgeons to identify tumor-free margins, and final pathological confirmation. We additionally evaluated operative duration, cost reduction, and reoperation rates. All analyses were performed using STATA software (version 14). The cohort demonstrated a predominance of invasive ductal carcinoma (IDC, 69.2%), with GME showing excellent performance for this subtype (sensitivity: 100%; specificity: 96%). Overall, GME exhibited moderate sensitivity (45%) but high specificity (95%) compared to final pathology, with positive and negative predictive values of 59% and 92% respectively. Notably, the use of intraoperative frozen tissue section excision significantly reduced operative time. Our results support GME as an effective margin assessment method in BCS candidates. The technique demonstrates particular strength in IDC cases while offering the practical benefits of reduced surgical duration and healthcare costs. These findings suggest GME represents a viable alternative to more resource-intensive margin evaluation approaches, especially in settings with limited pathology support. Excision of frozen tissue sections during surgery significantly reduces operative duration.